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Radiation therapy in the presence of non-transvenous cardiac implantable electronic devices: A case series
No full textAcute heart failure in eosinophilic granulomatosis with polyangiitis: A candidate for heart transplantation?
No full textDouble lung transplantation with simultaneous closure of the left atrial appendage with an epicardial clip
No full textIndications and findings of fetal echocardiography: a retrospective analysis of a high-risk cohort in a polish center
No full textObjectives: Fetal echocardiography (FE) is a critical diagnostic tool for assessing cardiac and extracardiac abnormalities in high-risk pregnancies. In this paper we evaluate indications and findings of FE in a high-risk cohort at a Polish fetal echocardiography clinic. Material and methods: This retrospective, observational cohort study included 991 patients undergoing FE between January 2023 and December 2024. A single prenatal cardiologist with extensive FE experience performed all examinations. Indications and findings were analyzed, with results categorized into subgroups. Results: Mean maternal age was 31.6 years (SD 5.3), with a median gestational age of 26 weeks (IQR = 4). The most frequent indications were intermediate risk of chromosomal aberrations from first-trimester screening (17.76%), intra-cardiac echogenic foci (13.32%), and elevated risk of chromosomal aberrations (12.82%), comprising 43.69% of referrals. Normal FE results were observed in 88.49% of cases (n = 877). Abnormalities (cardiac or extracardiac) occurred in 11.51%, with cardiac abnormalities in 7.16% (71 cases: 3.12% structural, 4.03% functional). Ventricular septal defect (1%) and arrhythmias (1.31%) were the most common structural and functional findings, respectively. Extracardiac abnormalities with normal cardiac imaging occurred in 4.3%. No significant differences in abnormality prevalence were found between high/intermediate chromosomal risk groups and the cohort (odds ratios: 0.47–1.14). Conclusions: First-trimester screening results and soft markers predominantly drove FE referrals. The 11.51% abnormality rate underscores the importance of FE in high-risk pregnancies, despite no significant association with chromosomal risk levels
Multidisciplinary management of an isolated pelvic hydatid cyst: a rare case of laparoscopic cystectomy with colpotomy and endobag extraction
No full textThe relationship between inspiratory muscle strength and exercise tolerance in patients with coronary heart disease
No full textBackground: There has been insufficient research on the assessment of exercise capacity in patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI) who exhibit inspiratory muscle weakness (IMW).
Methods: A retrospective cohort study involving CHD patients who underwent PCI at Peking University Third Hospital Heart Rehabilitation Center between January 2019 and December 2021 was conducted. Patients who had undergone inspiratory muscle testing and cardiopulmonary exercise testing (CPET) were included, and their clinical data were collected and analyzed.
Results: A total of 571 post-PCI CHD patients were included in the study. The average age was60.8 ± 4.3 years, and 479 male patients (83.9%) were included. The average maximal inspiratory pressure (MIP) of the enrolled patients was 90.7 ± 26.1 cm H2O, with 56 patients (9.8%) presenting with IMW. The IMW group had lower peak oxygen uptake (VO2peak) (17.4 ± 4.2 vs. 19.3 ± 5.1 mL//min/kg, p < 0.001) and oxygen uptake efficiency slopes (OUES) (1464.7 ± 368.5 vs. 1619.2 ± 400.4, p = 0.004). MIP correlated with VO2peak (r = 0.719, p < 0.001) and OUES (r = 0.622, p < 0.001). Multivariate regression analysis revealed that VO2peak (OR = 0.917, 95% CI = 0.858 ~ 0.980) and history of chronic obstructive pulmonary disease (COPD) (OR = 1.705, 95% CI = 0.934~ 3.112) were independent risk factors for IMW.
Conclusions: After PCI, CHD patients exhibiting IMW, especially those with comorbid COPD, demonstrated reduced exercise tolerance and oxygen uptake efficiency
Neurological hospitalizations of patients with a history of past or present malignancy — an observational study from a tertiary neurology center
No full textIntroduction. Cancer and its treatment are causing a wide range of neurological complications. Current epidemiological studies on neurological hospitalizations in patients with history of malignancy and active cancer (AC) are lacking. The aim of the study was to assess the numbers and clinical profiles of patients with history of malignancy and AC among patients hospitalized in neurological departments of the University Hospital in Cracow, Poland.
Material and methods. Medical files of all patients who were treated in neurological departments of the University Hospital in Cracow, Poland, from January 2022 to March 2024 were reviewed. Included were patients with a confirmed history of past or present malignancy. The profile of malignancies and reasons for neurological hospitalizations were analyzed.
Results. Among all patients hospitalized in the neurological departments 10.5% had a history of past or present malignancy and 4.9% had AC. The profile of malignancies and reasons for neurological hospitalizations differed among patients with AC and non-active malignancies. In 30.7% of AC the diagnosis of cancer was made (or the diagnostic process started) during hospitalization in the neurological department.
Conclusions. Neurological complications of cancer and its treatment are very common in everyday practice of neurohospitalists and require multidisciplinary care, as well as good cooperation between oncologists and neurologists
Experts’ position on durvalumab treatment for cholangiocarcinoma patients
Full text linkIn the Polish population, biliary tract cancers account for about 1% of the incidence and 2.5% of deaths due to all cancers, with 85% of all cases diagnosed in patients over the age of 60. Biliary tract cancer is a neoplasm that originates from intrahepatic or extrahepatic biliary epithelial cells and shows features of cholangiocyte differentiation. It can also develop from perihilar glands and hepatocytes. It is characterized by a poor prognosis, while the use of exclusive chemotherapy in the treatment leads to a slight improvement in the treatment effect.
The paper presents current guidelines for imaging and endoscopic diagnosis in patients with biliary tract cancer and summarizes data on the efficacy and safety of durvalumab from clinical trials as well as everyday clinical practice
Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?
Full text linkObjectives: Determine whether introital pelvic floor sonography with transvaginal probe (PFS-TV) can be an independent method in the diagnosis of genuine stress urinary incontinence (SUI) and to create a ultrasonographic diagnostic model to objectify diagnostic process. Material and methods: The study involved 315 patients with a history of urinary incontinence problems. Based on the clinical examination and urodynamic examination, the final diagnosis was made. Patients were divided into two groups. Group I included women with SUI and Group II included patients without SUI (OAB and no-UI). Each patient underwent PFS-TV at rest and during straining. The groups were compared in terms of ultrasound parameters. Results: Patients from both groups differed statistically in a significant way (p < 0.05) in terms of mean distance between the lower edge of the pubic symphysis at rest 19 mm vs 22 mm (Group I vs Group II) and during straining (D1 and D2) 22 mm vs 26 mm, the average value of the γ angle (at rest (γ1) 37.5° vs 40° and during straining (γ2) and 66° vs 58.5°, average difference value of angle γ during straining and at rest (γ2−γ1) 29° vs 14°, and frequency of urethral funneling 89% vs 17%. Two parameters studied during PFS-TV were included in the logistic regression model used to exclude the stress component of urinary incontinence. Diagnostic test parameters of model were sensitivity 86.6%, specificity 90.4%, accuracy 93.1%. Conclusions: PFS-TV makes it possible to exclude the stress component of urinary incontinence. The developed logistic regression model allows for the objectification of the results of ultrasound examination in patients with urinary incontinence
Diagnostic trends in patients hospitalized with suspected myocarditis: 10-year data from the nationwide MYO-PL database
No full textBackground: Myocarditis poses a great diagnostic challenge to clinicians, as the most sensitive diagnostic tools are not easily accessible in many hospitals. Clinical suspicion of myocarditis is based on clinical symptoms and additional tests’ abnormalities. The diagnosis should be confirmed by endomyocardial biopsy (EMB) — the gold standard for the diagnosis of myocarditis. The study aimed to assess trends in the use of diagnostic procedures performed in all patients hospitalized with suspected myocarditis in Poland between 2011–2019.
Methods: The nationwide MYO-PL database was derived from the database of the national healthcare insurer and created to identify hospitalization records with a primary diagnosis of myocarditis. We evaluated the use of recommended diagnostic procedures in this group of 19 978 patients within 6 months of the diagnosis of myocarditis.
Results: Echocardiography was the most frequently used imaging technique among patients, and the number of patients who underwent this procedure between 2011–2019 rose every year (71.3–86.1%). Use of nuclear medicine procedures remained < 1% regardless of the year. Biomarkers measurements during primary hospitalization were performed in 13.8% (brain natriuretic peptides) and 41.3% (troponins) of patients. Interestingly, EMB was performed in less than 1% of patients. The most sensitive noninvasive test (cardiac magnetic resonance) was performed in 16.4% of patients (7.2–29.2% within 10 years). Most diagnostic tests were less frequently performed in females.
Conclusions: The results highlight that the management of patients with myocarditis could be significantly improved if state-of-the-art diagnostic methods were followed according to guidelines